As part of this year’s Provider Directory & Data Summit, hosted by BetterDoctor, we had over 40 attendees gather at Google Launchpad to talk about provider data management, how to fix provider rosters, and how to overcome regulatory challenges facing providers and health plans.
People from diverse backgrounds joined — from health plans to individual brokers — to bring solutions to the longstanding problem of inaccurate provider data. Healthcare industry leaders took the stage and had dynamic conversations with our audience about what the new future of healthcare will look like with accurate provider data, what the blockers are, and how to overcome legacy technology challenges. The attendees agreed that more transparency and collaboration will need to happen in the industry to fix the provider data problem as a whole and to eventually improve provider directories for both industry and consumer use. Below we recap and include videos of our panels from the summit. Enjoy!
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Welcome + BetterDoctor Story
Provider Data touches most health plan functions from regulatory compliance, provider directory maintenance to care management and network development. With our welcome talk, we challenged our summit attendees to think about ways to improve the consumer experience.
Check out the video](https://www.youtube.com/watch?v=oKqCJ8RXxeo&feature=youtu.be): Ari Tulla, CEO & Co-Founder of BetterDoctor, opens up Annual Provider Directory & Data Summit 2017 to talk all things provider data management and the future of healthcare.
Provider data validation case studies and best practices
In this session, Paul Winder, from Washington Health Exchange, talked about how their provider data approach with BetterDoctor improved and enhanced their open enrollment operations this year. Additionally, John Rudoy, Principal of Health and Life Sciences at Oliver Wyman, spoke more broadly about how accurate provider data is important to shifting from a fee for service model to a value based service model of healthcare.
The panel also touched on how regulatory compliance is very important to health plans. BetterDoctor’s work was born to help meet this need with a technologically advanced and iterable approach.
There are many use cases in which accurate provider data management is key. Use cases include: care management, credentialing network management, network adequacy, consumer shopping experience (when selecting plans), and reducing providers’ administrative burdens.
Paul Winder, from the Washington Health Exchange, shared how un-normalized data previously caused problems in their healthplanfinder, the online tool where consumers find doctors. Consumers had trouble finding in-network providers because their data was not normalized. After leveraging BetterDoctor’s outreach and attestation technology, the Washington Health Exchange has been able to fix this and offer a better experience for patients. For example, they were able to verify in what way a hospital or medical center wants to be represented on healthplanfinder rather than struggling to get multiple different health plans to agree on one naming convention.
John Rudoy, from Oliver Wyman, talked about network development and how health plans need to understand the quality of the providers they are including in their networks. Network design is changing and now there is a different opportunity to analyze data to help refer patients to the right providers. He also shared how providers will be affected when value based healthcare becomes more prominent. As providers think through this, they have questions about their payments and there will be an opportunity to analyze the (true) costs of their services.
When talking about how health plans lack of confidence in group rosters, the group discussed possible mechanisms to get that data cleaned up in order to ingest updated data. One health plan attendee put it this way, “We have 14 medical groups that we work with and we are compiling all that data….and it’s a struggle for us to have [the organization we work with] ask us to provide accurate data while at the same time getting - what we believe - is inaccurate data from 13 groups and we can’t persuade [the groups] to update their data or even improve the accuracy. We really struggle with having faith in what we’re providing…to say ‘we believe in this data, you can put it in your directory.’ We are heavily reliant on BetterDoctor to solve this problem.”
- Paul Winder, Senior Plan Manager, Washington Health Benefit Exchange
- John Rudoy, Principal, Health and Life Sciences at Oliver Wyman
Provider data policy and regulation
Athena Chapman, from California Association of Health Plans, gave us the rundown of the feedback they have heard from health plans on SB-137. The good, the bad, and the ugly. She answers how regulators will move forward with provider directory laws in the next few years.
What is the biggest problem? There is no single source of truth for provider data. Health plans face lots of challenges when they’re updating their provider directory but the biggest issue is that there are multiple sources of data and trusting the accuracy of these sources is questionable. Overall, she presents the different provider directory efforts happening in California.
David Brewster, at the American Academy of Dermatology Association, works with providers who deal with a really heavy administrative burden. They have a hard time receiving so many requests to update their information. He explained that without a central repository place to update their data, providers will have a really hard time helping to keep the data accurate. Moreover, attestations are key so that providers can keep track on who they are updating their information with.
Charles Boorady, from Health Catalyst Capital, made the case that public private partnerships are essential to solve the provider directory data problem. No one entity can solve this issue; this is a problem that is going to require good policy and effective partnerships between both public and private players.
- Athena Chapman, Vice President Of State Programs, California Association Of Health Plans (CAHP)
- David Brewster, Assistant Director of Practice Advocacy, American Academy of Dermatology Association
- Charles Boorady, Founding Manager Director, Health Catalyst Capital
Provider Group Rosters - how do you fix the data?
This talk broke down the problem of updating provider data with group rosters to its elemental pieces. Christina Taylor, from BetterDoctor, examined where the problem starts, how complex data exchange gets, and how we need to share data more to help accomplish our goal of having accurate provider directory data to ultimately help consumers find doctors.
Why is it that provider data can be so complex? The truth is that providers are contracted with hospital groups, health plans, and/or for themselves. This talk gets down to the details.
Check out the video: Christina Taylor, Provider Group Rosters - How the fix provider data?
- Christina Taylor, Sr. Program Manager, BetterDoctor
Panel: How does provider data improve the consumer experience?
In this panel, we looked outside of the provider directory and data world. Health tech entrepreneurs took the stage to discuss the importance of creating a user-first experience for consumers to help them find the care that they need.
Stephanie Tilenius, CEO and Co-Founder of Vida Health, gave a demo of a patient that uses Vida to help him cope with diabetes, hypertension, depression, and high blood pressure. If a patient has diabetes, the patient gets introduced into a coaching program. Users can also track food, blood pressure measurements, and work towards weight loss goals. They even have a behavioral science based dashboard where each user can track their progress and success along the way. In her past experience working for eBay and Google — companies that are consumer focused— she learned that building a user-first experience is vital to innovating and growing.
Daniel Kivatinos, COO & Co-Founder at Drchrono, demonstrated how Drchrono has designed and digitized medical records to reduce the administrative burden on providers. They are simplifying physician’s workflows so that they spend time doing what they do best, taking care of patients.
Vincent Reyes, Area Vice President at Lyft, shared their work in the healthcare space. Lyft is an on-demand car service, an alternative to owning a car (which is a $9,000 annual expense). Lyft created a team to focus on healthcare so that they can help people get (non-emergency) medical rides to appointments. They’ve partnered with hospitals, clinics doing trial testing, and EHR companies so transportation could be booked. They are putting the user first and helping people access healthcare in a better, more affordable way.
Check out the video: Panel discussion - How Does Provider Data Improve the Consumer Experience?]